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Chronic noncommunicable diseases (NCDs) such as hypertension, atherosclerosis, acute myocardial infarction, stroke, diabetes, obesity, and chronic kidney disease are the major cause of death not only in high income, but also in medium and low income countries. Hypertension and diabetes, the most common causes of chronic kidney disease, are particularly common in southeast Asian Countries. Because early intervention can markedly slow the progression of these two killer diseases, assessment of their presence through screening and intervention program is a priority. We summarize here results of the screening activities and the perspectives of a noncommunicable diseases project started in West Bengal, India, in collaboration with the Institute for Indian Mother and Child (IIMC), a nongovernmental voluntary organization committed to promoting child and maternal health. We started investigating hypertension and chronic kidney disease with screen in school-age children and in adults >30 years old. We found a remarkable prevalence of hypertension, even in underweight subjects, in both children and adult populations. A glomerular filtration rate <60 mL/min was found in 4.1% of adult subjects significantly higher than that of 0.8% to 1.4% reported 10 years ago. Increased awareness and intervention projects to identify NCDs and block their progression are necessary in all countries.

Aim: Hypertension (HTN) and chronic kidney disease (CKD) are important emerging problems in low-income countries, with an increasing number of patients dying from their consequences. Methods: A project for investigating these issues was carried out in West Bengal, India, in 2536 adult subjects. Body mass index (BMI) was classified using traditional and new cut-offs identified by the World Health Organization for Asian populations. HTN was classified according to the Joint National Committee 7 and CKD according to presence of estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m2. Results: Normal BMI (Asian reference) was found in 41.5% of subjects, while 33.4% were underweight, 19.3% overweight and 5.8% obese. Prevalence of stage 1 and 2 HTN was 39.4%. Proteinuria (urine dipstick >1+) was present in 7.7% of the sample. In a subsample of 1526 subjects, eGFR of less than 60 mL/min per 1.73 m2 was found in 4.2%. At multivariate analysis, factors associated with HTN were weight classes (P < 0.001), presence of proteinuria (P < 0.001) and family history of HTN (P = 0.028), while living in rural areas was associated with lower risk for HTN (P = 0.003). eGFR was inversely related to BMI (P = 0.03), the presence of proteinuria (P < 0.001) and HTN (P < 0.003), and directly related to living in rural areas (P = 0.003). Conclusion: High prevalence of HTN was found in subjects with very limited access to health care in West Bengal. HTN was more common in overweight individuals, but also affected normal weight and underweight subjects in a significant part of the tested population. Preventive medicine should be a strong priority in this setting.

OBJECTIVES: To calculate an index (termed Pmusc/Eadi index) relating the pressure generated by the respiratory muscles (Pmusc) to the electrical activity of the diaphragm (Eadi), during assisted mechanical ventilation and to assess if the Pmusc/Eadi index is affected by the type and level of ventilator assistance. The Pmusc/Eadi index was also used to measure the patient's inspiratory effort from Eadi without esophageal pressure. DESIGN: Crossover study. SETTING: One general ICU. PATIENTS: Ten patients undergoing assisted ventilation. INTERVENTION: Pressure support and neurally adjusted ventilator assist delivered, each, at three levels of ventilatory assistance. MEASUREMENT AND MAIN RESULTS: Airways flow and pressure, esophageal pressure, and Eadi were continuously recorded. Sixty tidal volumes for each ventilator settings were analyzed off-line, at three time points during inspiration. For each time point, Pmusc/Eadi index was calculated. Pmusc/Eadi index was also calculated from airway pressure drop during end-expiratory occlusions. Pmusc/Eadi index was very variable among patients, but within one patient it was not affected by type and level of ventilator assistance. Pmusc/Eadi index decreased during the inspiration. Pmusc/Eadi index obtained during an occlusion from airway pressure swing was tightly correlated with that derived from esophageal pressure during tidal ventilation and allowed to estimate pressure time product. CONCLUSIONS: Pmusc is tightly related to Eadi, by a proportionality coefficient that we termed Pmusc/Eadi index, stable within each patient under different conditions of ventilator assistance. The derivation of the Pmusc/Eadi index from Eadi and airway pressure during an expiratory occlusion enables a continuous estimate of patient's inspiratory effort.

BACKGROUND: To assess the prevalence of hypertension (H), prehypertension (PH), and transient elevated blood pressure (TH) and their relationship with weight class and waist circumference (WC) in an unselected population of Northern Italian children. METHODS: A cross-sectional study was conducted in 5,131 children (5-11 years). Weight class was defined according to the International Obesity Task Force references, H and PH according to the National High Blood Pressure Education Program. A child was classified as having PH or H when systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) at first screening were > or =90th percentile and the mean of three subsequent measures was between the 90th and 95th or > or =95th percentile, respectively. When BP values at the first screening were > or =90th percentile but the mean of three subsequent measures was <90th percentile the child was classified as having TH. RESULTS: A proportion of 3.4% presented H, 2.7% PH, and 10.4% TH, 20% overweight, and 6% obesity. Weight class and WC were significantly associated to an increased risk of falling into any of the hypertensive categories. In children with TH BP z-scores of the mean of the three subsequent measurements following the first screening were significantly higher than BP z-scores observed in normotensive children (P value <0.001). CONCLUSIONS: Weight class and WC are associated with BP. This is observed not only for H but also for PH, and for nonsustained forms of H. Prospective studies are needed to assess whether children with PH and TH will develop sustained H.

We analyze in detail photon production induced by a superluminal refractive-index perturbation in realistic experimental operating conditions. The interaction between the refractive-index perturbation and the quantum vacuum fluctuations of the electromagnetic field leads to the production of photon pairs. © 2010 The American Physical Society

In the framework of transformation optics, we show that the propagation of a locally superluminal refractive index perturbation (RIP) in a Kerr medium can be described, in the eikonal approximation, by means of a stationary metric, which we prove to be of Gordon type. Under suitable hypotheses on the RIP, we obtain a stationary but not static metric, which is characterized by an ergosphere and by a peculiar behaviour of the geodesics, which are studied numerically, also accounting for material dispersion. Finally, the equation to be satisfied by an event horizon is also displayed and briefly discussed. © IOP Publishing Ltd and Deutsche Physikalische Gesellschaft.

Event horizons of astrophysical black holes and gravitational analogues have been predicted to excite the quantum vacuum and give rise to the emission of quanta, known as Hawking radiation. We experimentally create such a gravitational analogue using ultrashort laser pulse filaments and our measurements demonstrate a spontaneous emission of photons that confirms theoretical predictions. © 2010 The American Physical Society.

Pragmatics factors play an important role in experimental studies, as well as in common communicative exchanges, in interpreting experimenter questions. This paper experimentally investigates scalar implicature, a paradigmatic case of conversational implicature that is active at the violation of the Gricean maxim of Quantity: the use of a relatively weak term indicates that the speaker had reason not to use a more informative term from the same scale. The present work aims to investigate the pragmatic competence of scholar children with the scalar implicature produced by the quantifier "Some". Four experiments are presented. The first one aims to reply previous results (Noveck, 2001) by modifying some inappropriate aspects of that procedure (Control Experiment). Experiments 1 and 2 want to investigate the interpretation of the quantifier in a context which allows to choose what situation is better described by a sen tence; this is made in order to verify if children, when they can operate a choice, prefer the situation consistent with the pragmatic interpretation of the term. Experiment 3 investigates the production of the scalar implicature in a different context: this one explicitly defines the whole to which the quantifier is referring to. The aim of the study is to show that is fundamental an exhaustive communication of experimenter's intention, in order to detain children interpretation of scalar implicature. In the whole, results indicate that children interpret "Some" in the pragmatic way, when the experimenter's intention is clear to them. *** Scopo della ricerca è indagare la competenza pragmatica nei bambini relativamente alle implicature scalari. In particolare, i quattro esperimenti presentati hanno come oggetto la comprensione del quantificatore "Alcuni". Lo studio prende le mosse da un lavoro di Noveck (2001), che sembra dimostrare la difficoltà dei bambini nel comprendere il quantificatore "Alcuni" nella sua accezione pragmatica di "Alcuni...non tut